AB1147 COVID 19 INFECTION IN PATIENTS WITH RHEUMATIC IMMUNE-MEDIATED DISEASES IN A SINGLE UNIVERSITY HOSPITAL. MATCHED CASE-CONTROL STUDY.
Authors: D. Martínez-López, D. Prieto-Peña, F. Benavides-Villanueva, L. Sanchez-Bilbao, C. Corrales-Selaya, A. Herrero-Morant, C. Álvarez-Reguera, M. Trigueros-Vazquez, R. Wallman, M. A. González-Gay, R. Blanco
Journal: Annals of the Rheumatic Diseases (2022)

Background COVID19 may present different degrees of severity. It is generally thought that viral infections in patients with rheumatic inflammatory diseases (R-IMID) or receiving immunosuppressive treatment tend to present more severe disease. However, data comparing the severity of the disease between R-IMID and the general population are scarce. Objectives To assess the predisposing factors, clinical-analytical features and severity of COVID-19 infection in R-IMID compare to patients without R-IMID. Methods Case-control study in a single University Hospital. We included all consecutive patients with a diagnosis of a R-IMID and a positive test for COVID-19 up to March 31st, 2021. A total of 274 controls were selected for each case, and matched by sex, age (± 5 years), and without previous diagnosis of R-IMID or use of immunosuppresive therapy. Confirmed infection was defined if the patient had a positive nasopharyngeal swab for SARS-CoV-2. COVID-19 case severity was divided into mild, moderate, severe and critical according to the United States National Institute of Health (NIH) COVID-19 guidelines (1). Mild/moderate COVID19 was compared with critical. Results We included 274 patients (185 women/89 men), mean age 59.1 18 years. More frequent R-IMID were: Rheumatoid arthritis (RA) (n=87, 31.8%), Axial spondyloarthritis/ Psoriatic arthritis (SpA/PsA) (n=90, 32.8%), Polymyalgia Rheumatica (PMR) (n=22, 8%) and Systemic Lupus Erythematosus (SLE) (n=22, 8%) We also included 274 age and matched controls. Main characteristics of patients with R-IMID and controls are shown in Table 1 . Table 1. Main clinical and analytical features of patients with R-IMID and matched controls R-IMID patients (n=274 ) Controls (n=274 ) P Age 59.1±18 58.8±17.3 0.842 Sex F/M, n, (%) 185/89 (67.5/32.5) 185/89 (67.5/32.5) 1 Comorbidities (n,% ) Hypertension 119 (43.4) 84 (30.7) 0.0026* Dyslipidemia 119 (43.4) 79 (28.8) 0.0005* Diabetes mellitus 36 (13.1) 37 (13.5) 1 Pulmonary disease 29 (10.6) 32 (11.7) 0.79 Cardiovascular disease 45 (16.4) 33 (12) 0.18 Severity of the disease (n, %) Mild 209 (76.3) 204 (74.5) 0.69 Moderate 35 (12.8) 47 (17.2) 0.19 Severe 9 (3.3) 14 (5.1) 0.39 Critical 21 (7.7) 9 (3.3) 0.04* Deaths 17 (6.2) 7 (2.6) 0.0076* Analytical values, median [25-75th IQR] CRP 4.7 [2-9.3] 3.9 [1-7.3] 0.176 Lymphocytes (x103 /µL) 1 [0.6-1.5] 1.1 [0.8-2.5] 0.711 Platelets (x103 /µL) 179 [141-237] 174 [155-211] 0.722 D-Dimer (ng/mL) 999 [342-1417] 548 [336-997] 0.032* CRP: C-reactive protein. Concerning comorbidities, hypertension and dyslipidemia were more frequent in patients with R-IMID (p&lt; 0.05). COVID-19 symptoms’ distribution is shown in Figure 1. Figure 1. Symptoms in R-IMID patients and matched controls *: p &lt; 0.05 Cough and dyspnoea were more frequent and headache, odynophagia and diarrhea were less frequent in the R-IMID group. The only analytical difference was D-Dimer that was significantly higher in patients with R-IMID. Although most of the cases were mild, critical cases and deaths were more frequent in R-IMID (p &lt;0.05). Conclusion Most of the patients present a mild COVID-19. However, a more severe syndrome was observed in R-IMID References [1]COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. National Institutes of Health. Available at https://www.covid19treatmentguidelines.nih.gov/ . Accessed [insert date]. Disclosure of Interests David Martínez-López: None declared, Diana Prieto-Peña: None declared, Fabricio Benavides-Villanueva: None declared, Lara Sanchez-Bilbao: None declared, Cristina Corrales-Selaya: None declared, Alba Herrero-Morant: None declared, Carmen Álvarez-Reguera: None declared, Martin Trigueros-Vazquez: None declared, Reinhard Wallman: None declared, Miguel A González-Gay Speakers bureau: Consultation fees/participation in company-sponsored speaker´s bureau from Abbvie, Pfizer, Roche, and MSD., Grant/research support from: Dr. Miguel A. Gonzalez-Gay received grants/research supports from Abbvie, MSD, and Roche., Ricardo Blanco Speakers bureau: Consultation fees/participation in company-sponsored speaker´s bureau from Abbvie, Lilly, Pfizer, Roche, Bristol-Myers, Janssen, and MSD., Grant/research support from: Dr. Ricardo Blanco received grants/research supports from Abbvie, MSD, and Roche